SIRI、FAR和ALP对前列腺癌骨转移的预测价值  

Evaluation the predictive value of SIRI,FAR and ALP for bone metastasis of prostate cancer

作　　者：谢文亮 邱逸凡 臧晋[1] XIE Wenliang;QIU Yifan;ZANG Jin(Department of Urology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院泌尿外科,215006

出　　处：《现代泌尿生殖肿瘤杂志》2022年第5期282-287,315,共7页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨全身炎症反应指数(SIRI)、纤维蛋白原与白蛋白比值(FAR)和碱性磷酸酶(ALP)对前列腺癌骨转移的预测价值。方法回顾性分析2019年1月至2021年12月苏州大学附属第一医院泌尿外科收治的657例前列腺癌患者的临床资料,根据全身骨扫描的结果分为骨转移组和非骨转移组。通过卡方检验和秩和检验比较两组一般临床指标的差异,通过单因素及多因素Logistic回归分析确定前列腺癌患者骨转移的独立危险因素,通过受试者工作特征(ROC)曲线分析各预测指标的截断值、敏感度及特异性。结果657例患者中,骨转移组124例(18.9%),非骨转移组533例(81.1%)。骨转移部位发生率排名前3的分别是髂骨(88例,70.97%)、耻骨(81例,65.32%)和坐骨(76例,61.29%)。骨转移组SIRI、FAR和ALP的中位数分别为1.31×10^(9)/L(0.82×10^(9)/L~1.93×10^(9)/L)、0.95(0.81~1.36)、151.85(86.98~332.60)U/L,明显高于非骨转移组[分别为0.64×10^(9)/L(0.44×10^(9)/L~1.00×10^(9)/L)、0.67(0.58~0.79)、63.80(55.10~78.05)U/L],差异具有统计学意义(P<0.001)。单因素及多因素Logistic回归分析表明,SIRI、FAR、ALP、总前列腺特异性抗原(tPSA)、Gleason评分和临床分期是前列腺癌骨转移的独立危险因素。各个独立预测因素联合诊断前列腺癌骨转移的ROC曲线下面积(AUC)为0.971,优于单独的预测指标SIRI(AUC=0.763)、FAR(AUC=0.832)、ALP(AUC=0.879)、tPSA(AUC=0.881)、Gleason评分(AUC=0.782)和临床分期(AUC=0.782)。结论SIRI、FAR、ALP是前列腺癌患者骨转移的独立危险因素,联合SIRI、FAR、ALP与传统预测指标(tPSA、Gleason评分和临床分期)能够提高对前列腺癌骨转移的预测效能,有助于临床早期预测前列腺癌患者骨转移的风险,评估全身骨扫描检查的必要性。Objective To explore the respective clinical values of systemic inflammation response index(SIRI),fibrinogen-to-albumin ratio(FAR)and alkaline phosphatase(ALP)in predicting bone metastasis in patients with preliminarily diagnosed of prostate cancer.Methods The clinical statistics of 657 prostate cancer patients diagnosed by the Department of Urology of First Hospital of Soochow University from January 2019 to December 2021 were included into the trial through retrospectively analyzing the clinical data.All of whom were distributed into the respective 2 groups(bone metastasis group and non-bone metastasis group)on the basis of the cancer bone metastasis situation,in compliance with the outcome of the whole body bone scan comprehensively.The differences in general clinical data between the 2 groups were compared by Mann-Whitney U test and chisquare test,independent risk factors for bone metastasis in prostate cancer patients were determined specifically by the means of univariate and multivariate Logistic regression analysis,receiver operating characteristic(ROC)curve was utilized to analyze the cut-off values,sensitivities and specificities of each predictor.Results There were 124 cases(18.9%)in the bone metastasis group and 533 cases(81.1%)in the non-bone metastasis group.The top 3 anatomical sites of prone to bone metastasis were significantly ilium(n=88,70.97%),pubic bone(n=81,65.32%),and ischium(n=76,61.29%).The median of SIRI,FAR and ALP in patients with bone metastasis were respectively 1.31×10^(9)/L(0.82×10^(9)/L-1.93×10^(9)/L),0.95(0.81-1.36)and 151.85(86.98-332.60)U/L,which were remarkably higher than those in the other group being significantly 0.64×10^(9)/L(0.44×10^(9)/L-1.00×10^(9)/L),0.67(0.58-0.79)and 63.80(55.10-78.05)U/L.The differences were statistically significant(P<0.001).Both the univariate and multivariate Logistic regression analyses showed that SIRI,FAR,ALP,tPSA,Gleason score,and clinical stage were independent risk factors for predicting the probability of prostate cancer bone metast

关 键 词：前列腺癌 骨转移 预测模型 外周血指标 

分 类 号：R737.25[医药卫生—肿瘤]